AANA Journal course: update for nurse anesthetists--thoracic trauma

The lungs are remarkably resilient organs and injuries to the lungs, whether from blunt or penetrating trauma, are not often the source of mortality. Instead, associated injuries to the heart, great vessels, chest wall, and other critical structures account for most morbidity and mortality associated with thoracic trauma. Hypovolemic shock, impending cardiac failure, neurological injury, and compromised respiratory function may all be present in a single individual with thoracic trauma whose injuries require immediate surgery. Anesthesia care for the thoracic trauma patient often involves continued resuscitation to combat shock, as well as the careful administration of anesthetic agents. The choice of anesthetic agents must consider the patient's hemodynamic status, the potential for airway problems, associated injuries, and medical history.